In the Race for Market Share, Sometimes You Can’t Afford a Twelve-Month Design Process

August 8, 2014 | Scott Garand

Typically when designing a new building, the team holds meetings to review design concepts, the client suggests modifications, the design team refines the design, and then a subsequent meeting is held to review the progress, often with two-week gaps between each step.

This approach is linear, time consuming, and requires significant amounts of coordination for meetings by the Owner. The sequential format of Schematic Design, Design Development, and Construction Documents may not be fast enough in today’s healthcare environment.

We have found that a Lean design process can accelerate the design timeline while producing superior results with improved staff buy-in.

One component of our Lean process is the Kaizen event, a four day group exercise where we work to achieve staff buy-in on operational processes and a schematic design that align with strategic goals.

TEAM MEMBERS, MEASURABLE GOALS AND EARLY CONSENSUS
We recruit a range of participants to optimize each Kaizen event. For instance, when analyzing a mother/baby postpartum room, we invite the nursing staff, a new mother, a pediatrician, a labor and delivery nurse, and an administrator who can substantiate community market share targets. Rather than simply aspiring to “improve care,” the team defines precise objectives against which to measure the effectiveness of proposed solutions.

As one example, we challenged ourselves to reduce travel times by 10% so the nurse can spend more time at the bedside. The team can measure progress against a quantified goal as the design changes through multiple iterations. Regardless of the objective, it is critical to clearly and objectively state a clear vision to build early consensus among key players to increase their willingness to execute it.

FISHBONE DIAGRAMS
Fishbone diagramming exercises help team members identify the impacts of key people, equipment items, IT needs, and furnishings on each programmatic area. Because these impacts are determined early in the Kaizen event rather than several months into the project, the operations help define the facilities, rather than the facilities driving the operations.

OBJECTIVE ADJACENCY CONSENSUS
We rapidly develop seven adjacency scenarios using components from a pre-determined and approved project program. These seven scenarios are then scored against the Kaizen event goals based upon a scale of 1 to 5, with 5 representing the closest alignment to a goal. The scores are then tabulated in a matrix format. Because the highest scoring scenario is determined quantitatively rather than upon subjective preference, we are more likely to achieve team buy-in.

MOCK-UP CONSTRUCTION AND SIMULATION
Participants can test the functionality of a space more easily in a life-sized physical mockup. As part of our Kaizen events, we construct physical models out of easily-maneuvered cardboard panels to communicate the design of critical spaces. By doing so, we can locate equipment, outlets, door swings, and viewing windows earlier in the process. Staff role-play different clinical simulations in the mockup space to assess what works in the configurations and make adjustments to the design.

30 / 60 / 90 DAY FOLLOW UP
After the Kaizen event is complete, we continue to refine the solution and address outstanding items in a series of meetings with selected attendees. During these meetings we focus on engineering systems, code analysis, life safety coordination, and logistical refinements in order to develop permit documents that represent the conclusions developed during the Kaizen event.

In a Lean Process approach, instead of sequential single steps with individual stakeholders, Kaizen events bring everyone into the same room at the same time and reach consensus as a group. Parallel processes occur simultaneously and inform one another, resulting in a compressed design schedule. A compressed design schedule means the project is built sooner, and you can start earning or maintaining market share ahead of your competitors.